Genomic and metabolic hallmarks of SDH- and FH-deficient renal cell carcinomas Journal Article


Authors: Yoo, A.; Tang, C.; Zucker, M.; Fitzgerald, K.; DiNatale, R. G.; Rappold, P. M.; Weiss, K.; Freeman, B.; Lee, C. H.; Schultz, N.; Motzer, R.; Russo, P.; Coleman, J.; Reuter, V. E.; Chen, Y. B.; Carlo, M. I.; Gill, A. J.; Kotecha, R. R.; Ari Hakimi, A.; Reznik, E.
Article Title: Genomic and metabolic hallmarks of SDH- and FH-deficient renal cell carcinomas
Abstract: Background: Succinate dehydrogenase-deficient and fumarate hydratase-deficient renal cell carcinomas (SDHRCC and FHRCC) are rare kidney cancers driven by loss of TCA cycle enzymes. Objective: To define and compare the genomic and metabolomic hallmarks of SDHRCC and FHRCC. Design, setting, and participants: We analyzed SDHRCC and FHRCC tumors with either immunohistochemical evidence of loss of protein expression or genomically confirmed biallelic inactivation of SDHA/B/C/D/AF2 or FH. Outcome measurements and statistical analysis: Somatic alterations were identified using clinical pipelines, with allele-specific copy number alterations (CNAs) identified using FACETS. Mass spectrometry–based metabolomic profiling was performed on available SDHRCC and FHRCC tumors. Results and limitations: Tumors were analyzed for 42 patients (25 FHRCC, 17 SDHRCC). In the germline analysis, 16/17 SDHRCCs harbored a germline alteration in SDHB, whereas only 17/22 FHRCCs had pathogenic germline FH variants. SDHRCCs had a lower mutation burden (p = 0.02) and CNA burden (p = 0.0002) than FHRCCs. All SDHRCCs presented with deletion of chromosome 1p (overlapping SDHB), whereas FHRCCs demonstrated high but not ubiquitous loss of 1q (FH locus). Both SDHRCCs and FHRCCs exhibited significant idiopathic accumulation of the metabolite guanine. FHRCC tumors had elevated levels of urea cycle metabolites (argininosuccinate, citrulline, and fumarate), whereas SDHRCC tumors had elevation of numerous acylcarnitines. These characteristic metabolic changes allowed identification of a previously unrecognized SDH-deficient RCC. Conclusions: Despite sharing similar genetic etiology, SDHRCC and FHRCC represent distinct molecular entities with unique genetic and metabolic abnormalities. Patient summary: Kidney cancers driven by loss of the gene encoding either the succinate dehydrogenase or fumarate hydratase enzyme are rare. We sought to define and compare the genetic and metabolic features of these cancer entities. © 2021 The Authors
Keywords: genetics; metabolism; pathology; renal cell carcinoma; kidney neoplasms; kidney tumor; carcinoma, renal cell; genomics; cancer genomics; fumarate hydratase; succinate dehydrogenase; humans; human; fh; sdh; fhrcc; sdhrcc
Journal Title: European Urology Focus
Volume: 8
Issue: 5
ISSN: 2405-4569
Publisher: Elsevier B.V.  
Date Published: 2022-09-01
Start Page: 1278
End Page: 1288
Language: English
DOI: 10.1016/j.euf.2021.12.002
PUBMED: 35288096
PROVIDER: scopus
PMCID: PMC9464266
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK authors are Ritesh Kotecha, A. Ari Hakimi, and Ed Rednik -- Export Date: 1 February 2023 -- Source: Scopus
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MSK Authors
  1. Jonathan Coleman
    343 Coleman
  2. Paul Russo
    581 Russo
  3. Robert Motzer
    1243 Motzer
  4. Yingbei Chen
    398 Chen
  5. Victor Reuter
    1228 Reuter
  6. Nikolaus D Schultz
    487 Schultz
  7. Abraham Ari Hakimi
    324 Hakimi
  8. Maria Isabel Carlo
    162 Carlo
  9. Eduard Reznik
    103 Reznik
  10. Chung-Han   Lee
    157 Lee
  11. Ritesh Rajesh Kotecha
    92 Kotecha
  12. Kate Weiss
    10 Weiss
  13. Mark Raymond Zucker
    12 Zucker
  14. Cerise Tang
    11 Tang
  15. Angela Y Yoo
    1 Yoo